ARTERIAL REMODELING AND CORONARY EVENTS

Abstract
Arterial remodeling is a bidirectional geometric alteration of the vessel wall in response to atherosclerosis. Expansive remodeling is histologically characterized by features of plaque vulnerability and inflammation, whereas constrictive remodeling possibly represents healed inflammatory processes or plaque rupture. It therefore has been suggested that remodeling may influence the long-term outcome after vascular interventions. We analyzed clinical, angiographic and IVUS data of 244 patients with stable angina undergoing percutaneous coronary revascularization. The patients were categorized into three groups (expansive, constrictive and intermediate remodeling, ER, CR and IR). At follow-up patients with CR had a higher rate of in-hospital complications In contrast, patients with ER had the highest rate of major adverse cardiac events (MACE). ER was a significant predictor of MACE in multivariate analysis. Despite the initial benefit of lumen maintenance, ER is thus associated with unfavorable outcome of coronary interventions. Further clinical implications and therapeutic approaches are discussed in this manuscript.

Key words
Atherosclerosis, vascular remodeling, intravascular ultrasound, coronary intervention, unstable angina.

Bibliografía del artículo

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